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In South Asia, the high costs of synthetic fertilizers have imposed research on alternative nutrient inputs. We aimed to identify potential trace elements (PTE) present in some organic manure that might be a source of environmental pollutions and risk to public health following consumption. The study aims to evaluate how different organic waste (poultry waste, PW; press mud, PM; and farmyard manure, FYM) influences the heavy metal migration in soil, the accumulation in garlic, and their potential health risks. Organic waste caused a higher accumulation of certain metals (Zn, Cu, Fe, and Co), whereas Mn, Cd, Cr, and Pb were in lower concentrations in soil. Amendments of soil with PM revealed a higher accumulation of Cd, Cr, Fe, and Pb, whereas PW resulted in Cu and Zn accumulation in garlic. Treatment of soil with FYM exhibited higher metal concentration of Co and Mn. An environmental hazard indices study revealed that pollution load index (PLI) was highest for Cu following treatment with PM. The health risk index (HRI) was greater for Cd following amendment with PM. Maximum daily intake of metals (DIM) was observed for Zn after treatment with PW. The Pb exhibited maximum bioconcentration factor (BCF) in PM-amended plants. Based on these findings, we concluded that garlic grown on contaminated soil with organic waste may pose serious health hazards following consumption.
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INTRODUCTION: Acute gastrointestinal bleeding (GIB) is a common surgical problem requiring hospitalization in the United Kingdom (UK) and Ireland. The first UK lower gastrointestinal bleeding (LGIB) management guidelines were published in 2019 by the British Society of Gastroenterology (BSG). We aimed to evaluate self-reported adherence to BSG clinical guidance (CG) within the UK and Ireland. METHODS AND MATERIALS: A Questionnaire was designed based on LGIB BSG CG 2019 using Google Forms (Google LLC, Mountain View, CA). This was distributed to surgical consultants and senior surgical practitioners (specialists, Trust grade registrars, and specialist registrars) across different centers in the UK and Ireland over four weeks (13th March to 5th April 2021). Data were analyzed using Statistical Package for Social Sciences (SPSS) version 27 (IBM Corp., Armonk, NY, USA). RESULTS: A total of 64 responses were recorded from 18 different centers in the UK and Ireland. The ratio of consultants and registrars was almost the same (34:30, 53.1%:46.9%). The majority of respondents were from colorectal surgery (65.6%, n=42) followed by general surgeons (23.4%, n=15). A total of 41 respondents (64.1%) admitted that BSG CG 2019 were practically applicable at their center. Approximately 75% of respondents did not use or were unaware of the Shock index or Oakland score to stratify patients. That translated into 59% opting to admit patients with a minor bleed. Around 36% wanted to perform a CT angiogram for a stable major bleed, while 37% were unaware of the interventional radiology (IR) referral pathway. CONCLUSION: There is patchy adherence to the guidelines leading to significant variations in LGIB management practice and avoidable admissions.
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Background Delayed diagnosis, unnecessary hospital admissions and extended length of stay are the problems associated with inappropriate access to radiological investigations. The acute surgical assessment unit (ASAU) in Limerick has two dedicated ultrasound scan (USS) slots daily to overcome this problem. The aim of the current study was to investigate the clinical impact on patient care and the cost-effectiveness of such an ASAU USS access. Methods A retrospective review of all patients who underwent USS investigation in the ASAU between May and September 2017 was conducted. Demographic, referral source, presenting complaint, and clinical outcome data were obtained from the ASAU Log. USS data was obtained from the National Integrated Medical System (NIMIS). The Integrated Patient Management System (IPMS) and Therefore Case Manager, Therefore 2014(12.0.2) was utilized to check for any discharged ASAU patient re-presenting to the emergency department (ED) within 30 days. Results A total of 102 patients underwent USS investigation during the study period. The most common presenting complaint was epigastric or right upper quadrant pain (55.8%). Eighty-six patients underwent USS on the same day and the majority (51%) were discharged home with appropriate outpatient follow-up. Approximately 26,000 Euros were saved over four months. Post-discharge ED visits in the ASAU discharged group was zero in the 30 days. Conclusion The ASAU USS dedicated slots in University Hospital Limerick has had a significant positive impact on patient diagnostics, surgical admissions rates and streamlining resource allocation. Having dedicated slots for radiological investigations in the ASAU should become standard of care across all healthcare jurisdictions.
